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CLIENT APPLICATION FOR SUPPORT

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Critical Care/Standard Program Eligibility

The Critical Care/Standard Program allows for Max's to provide financial support for treatment of your pet for up to $500 in diagnostics, up to 50% of necessary treatments to a maximum of $1,500.

ELIGIBILITY REQUIREMENTS

  • Your vet must provide you an authorization code
  • Pet owner must reside in Monterey County
  • Pet owners requesting above $500 must provide proof of income
  • Pet owners must provide copy of ID
  • Treatment must not have already taken place
Continued Care Program Eligibility

The Continued Care/Long Term Support Program allows for Max's to provide financial support for treatment of your pet for up to $500 in diagnostics, up to 50% of necessary treatments to a maximum of $6,000 for ongoing treatments for long term injury or illness over a two year period.

ELIGIBILITY REQUIREMENTS

  • Your vet must provide you an authorization code
  • Pet owner must reside in Monterey County
  • Pet owners requesting above $500 must provide proof of income
  • Pet owners must provide copy of ID
  • Treatment must not have already taken place
Chestnut Crisis Fund Program Eligibility

Chestnut's Crisis Fund allows for Max's to provide financial support for treatment of your pet for up to 75% of necessary treatments to a maximum of $2,500.

ELIGIBILITY REQUIREMENTS

  • Your treating veterinarian must provide you an authorization code
  • Pet owners must provide copy of ID
  • Pet owner must reside in Monterey County
  • Pet owners must be experiencing financial hardship due to an immediate reduction in wages from the impact of COVID 19 on their place of employment
  • Pet owners must provide ONLY ONE of these in order to receive support
    • Letter from employer noting reduction or elimination of work due to COVID 19 
    • Submission of two consecutive pay stubs - one prior to March 13
    • Copy of your application for Unemployment or government support
    • Proof of employment prior to March 13 at business known publicly to have reduced hours or closure
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PET OWNER & SPOUSE/PARTNER/PET CO-OWNER INFORMATION

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First Name
Last Name
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You must submit either through form or by sending photo of your ID/DL to admin@maxshelpingpaws.org

First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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PET INFORMATION

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(If you do not have a regular veterinarian, explain why not here)
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HOUSEHOLD FINANCIAL INFORMATION

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You must submit results from Care Credit Application in order to be considered
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HOUSEHOLD FINANCIAL INFORMATION





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(see accepted options noted in application)

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Please note we are not pay the entire cost of treatment. As a pet owner you are expected to incur some costs for the care of your pet.

Friends, family members, other non profits

I UNDERSTAND AND AGREE THAT:

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I accept and approve the above. If I receive assistance, I consent to use of my pet’s name, image & story by MHPF for website, PR, and other marketing purposes, AND I will cooperate with MHPF to schedule photos, interviews or video as necessary for their use.

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